Tuesday, February 09, 2010

A spoilt brat and his parents

I had lost my appetite since Monday evening, and had nausea since Tuesday morning. Thus, I only had some fluids since then. Add to that, yesterday was a busy day. 13 patients in all, including 2 admissions and 2 discharges, and a couple of cases that upgraded from 4 bedded rooms to double rooms.

Amongst these up-graders was a spoilt brat. Only 3 years old but he has both his parents twisted around his little finger. The worse part is both the parents show their love by pandering to their son's every silly little preference. E.g. Nebulizer whenever he is asleep, disregarding the 4 hourly timing ordered by the doctor, i.e. bring forward or backwards by more than an hour, and even skip doses.

When the boy's neighbour was discharged, the parents wanted to switch to the window-side bed and change to a cot bed for the boy. The parents kept harassing the staff to change his bed quickly and repeatedly, even before the neighbour had left the ward. When that was settled, the child moved to the cot bed. He kept jumping around on his cot bed, but neither parent would discipline the boy for his behaviour or advise him of the risk for fall or stay close to prevent falls. It was up to me, the "nasty nurse", to warn the boy of the risk for fall since the mother insisted on not having the cot-side up.

When it came to IV antibiotics, the boy kicked me, but the mother did not do or say anything even though she saw it. So it was up to "nasty nurse" to tell the boy, "Now boy, do you know that it is rude of you to kick others? You don't kick your friends, do you?" Only then, the embarrassed mother made a half-hearted attempt to get the boy to apologize, but of course the boy refused.

Due to his active nature, the IV cannula had backflowed and was leaking. Thus we had to bring him to the treatment room to check his IV site and re-splint the arm. The mother kept telling the nurses (all 3 of us) "Don't press on him, it's painful!", "Don't hold his hands so hard!", etc. Mind you, we were only holding down her boy to re-secure the IV cannula so that her son does not have to go through another round of pain from IV re-site. We had to explain to her repeatedly why we had to hold down his hands, and that we were minimizing any discomfort. She was obviously not convinced because she started saying her prayers aloud while we were working on her son.

Come evening when I had to give the boy his medications, the boy refused and the mother did not do anything about it. Fortunately the boy's grandaunts were visiting and they were not into such nonsense. After wasting 2 sweet chewable Singulair tablets because the boy spitted them onto the floor, I crushed a 3rd one and had to force feed him using the syringe. Initially, the grandaunt was attempting to feed him while I held down his hands. Due to the boy's struggling, we swapped roles. While we were feeding the boy, the mother kept say "Don't hold his hands", "Don't hold him so hard", etc.

By then, there was already a new admission into the other bed. Someone complained about a spoilt headset and the technician came to fix the problem. Apparently, someone had pulled the headphones plug off the spoilt brat's TV and blasted the TV volume up loud enough to be heard throughout the room. I advised the mother that I had to put the headphone plug back on, so as not to disturb the neighbour's rest. The mother refused to allow me to place back the headphone plug, citing that she would lower the volume instead.

Just before the end of the shift, the mother decided that indeed the child was too active to be on the cot bed (which was high) and wanted to change back to the adult bed. SN J, as in-charge, has had enough of her requests and instructed me to inform the mother that the hospital is full and we will try to arrange tomorrow instead.

As with other young spoilt brats that I have met, one only have to look at the parents or the main-caregivers for the reason.


[Addendum on 10-Feb-2010]

I was taking the team caring for the above child again today. As per the parents' preference, I gave the nebulizer at 2:30pm while the boy is sleeping, instead of 4pm as scheduled. The boy is a sound sleeper, did not wake up at all during the nebulization.

As today's workload was lighter earlier in the evening, the mother and I spent 40 minutes coaxing the child to agree to IV antibiotics. We even had to get help from the other family in the double room, to show the child that another child has the same antibiotics but did not complain of pain. As it turns out, it was worth the 40 minutes of time, winning over the mother and child.

In the evening, the child took his oral medications with minimal coaxing. Only then did he discover that all the stuff he resisted were actually sweet and yummy. I even helped the mother convince him to change his diapers by bribing him with stickers.

Just before my shift ended, there were 6 new admissions at the ward, of which 3 were under my team. 1 was a day surgery lodger, 1 was an adult male for complex migraine, and 1 was a paediatric patient. Fortunately senior SN Y was around to assist, while I took over the lodger and assist with the other team's admissions. One was an emergency case, that needed to be sent to ICU.

By the time the stuff was settled, it was already 1 hour past my knock-off time. Then I got an angry comment from the night shift HCA S that the child's parents complained of missing one dose of nebulizer. It caught me by surprise because I spent quite a long time earlier that afternoon to explain to the child's mother about his prescription and discuss alternative administration strategies. We agreed that we will not force the nebulizer on the child when it would be next due at 6:30pm, but wait for the father to arrive instead. Thus, I went to clarify with the parents. According to the parents, they only made a casual "FYI" remark, but HCA S mistook as a complaint. After clarifying with the parents, I updated senior SN R who was on night duty.

As I was leaving the ward, I saw the child's mother re-explaining to the senior SN R about the miscommunication. She even tried to talk to HCA S about it, but HCA S was too busy to attend to her. It really touches my heart that she bothered to stand up for me and clarified matters directly with the night staff.

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